Individual
NICHOLAS DESIMONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1395 CHEWS LANDING RD, LAUREL SPRINGS, NJ 08021
(856) 258-7575
Mailing address
1395 CHEWS LANDING RD, LAUREL SPRINGS, NJ 08021
(856) 258-7575
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
37LC00251500
NJ
101YM0800X
Mental Health Counselor
37LC00251500
NJ
101YP2500X
Professional Counselor
Primary
37PC00776800
NJ
Other
Enumeration date
02/07/2017
Last updated
07/16/2021
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